You know what other metal stays in the body, permanently bound to bone and other organs? Bismuth, as in bismuth salycilate, aka Peptobismol. A tiny % actually stays in your body.
Every time I've gotten an MRI the doctors and techs have sworn up and down it's impossible for this stuff to stick around. Getting tired of not being able to believe what doctors say...
Around 10 years ago, I had an brain MRI with contrast. I specifically googled it and found a paper saying it builds up in the brain. I asked the MRI specialist about it, she was surprised I knew this and said she was familiar with the research. She mentioned that her professor also knew about it, but that the paper had other motivations, some conflict of interest, and that I shouldn't be worried. FFS.
Literally every single medical procedure, down to the most mundane, has risks.
That's why we don't give MRI's out the wazoo. We actually gatekeep them a lot, and most research will tell you that investigative MRIs without chief complaints are a bad idea and we don't do them.
I had cancer. I had no MRIs, but multiple CT and PET scans. CT scans and PET scans have risk - they don't just do those for kicks. But you know what else has risks? Cancer. So there's a calculus here.
Every single medical procedure, down to getting your blood drawn, has this calculus. Nothing is risk free.
I find it odd that when I happen across an article talking about some negative links between x and y being discovered, there's always someone in the comments saying this was known for some decades.
This is very interesting to see on here. My mother was the dissenting vote on an FDA panel on this. There are articles about it. I'll copy her words (as reported by something but seems legit)
> She said that the FDA's plan doesn't go far enough.
> "It's hard to dismiss an anecdotal report when you are the anecdote. When a patient is finally tested and found to have gadolinium retention, there's no FDA-approved antidote. So what does the patient do?"
And I want to reiterate that she was "the" no not "a" no. I don't know if her vote alone is what's caused more research into this. But it's probably the thing I brag about her the most. Even though everybody else said it was fine or abstained, she stood strong. If you look up the articles from the time of the panel (2017) you'll see a lot of articles about this panel and how she was the sole no vote. Included in that was a public post from Chuck Norris praising her. He was going to come out to meet us but I think it was a bad Texas hurricane season so that fell through
Thanks - I've put that link in the toptext above. I'm not sure it makes sense to swap out the submitted URL with it. Hopefully people will take a look at both.
As someone with CKD and scheduled for an MRI, this was anxiety-inducing.
The Cleveland Clinic has a good overview[1]. Since there have been no reports of NSF in 15 years, I don't think it's rational to avoid MRIs based on gadolinium retention concerns.
I think the thing to remember with this, as with any kind of medical procedure, is the benefits versus the risks. In many cases, if you're getting this kind of MRI contrast, there's probably a good reason for it. So even if there's some risk, it might be better than say, the cancer or something else they're looking for. I feel like this is something that's often forgot in these discussions.
Great. Only this year, I got roughly 6 doses of gadlinium, and prior to that, I got one every year, going back 20 years. I just recently chatted with a MRI nurse about the fact that I have a bad feeling about getting that stuff so frequently over time, and she dismissed my concerns. They used to remind patients to drink more after the MRI, but even that routine has been ended roughly 5 years ago. Is there anything else I can do except drink more on the day of the injection?
My kid went to brain MRI because of migraines (standard procedure here for kids to check if there is e.g. a tumor causing the headache). I was pretty nervous due to this kind of research and the preparatory material saying that they might need to use a contrast agent. In the end they didn’t use a contrast agent and I stressed unnecessarily.
Note that MRI with contrast has very low risk and I am not aware of any evidence that Gadolinium retention even has adverse health effects. It is a concern though and this is why it is being studied. But I do not think the use of MRI contrast agents is something anybody without kidney disease should be concerned about. In general, risks and benefits must be balanced for any medical procedure. Such risks are continuously monitored and studied and guidelines are formulated based on this. Also consider that there is very clear harm from people being scared away by misinformation from medical procedures they would benefit from.
There are risks with every procedure and medication.
A dose of ibuprofen could give you Stevens–Johnson syndrome or TENS and you end up in a burn war for months.
Patients should be made aware of all the risks for any treatment, but it would be impossible to avoid they edge cases even with relatively basic medical care.
Gadolinium has killed many many people. Many healthy people like me became chronically ill due to Gadolinium based contrast agent. We all had healthy bodies no history of kidney issues. One dosage of gadolinium contrast and the body couldn’t handle the toxic element which is a heavy metal for the body. The body is not designed to remove this on its own. It destroys the tissue it contacts with. FDA has to pull this poison out.
It seems only patients with advanced renal disease are effected. So, my suggestion, no Gad in patients with increased Creatine (even Stage I renal disease).
My son had an MRI with gadolinium- turns out he is allergic to it, he developed a full-body itchy rash. There were like 20 interns in to see him, for the experience I guess. They were ready to send him to the ER in case it interfered with his breathing, luckily it didn't.
Interesting to see this on HN. I was part of the research group which published this back in 2015 [1], I think we were the second group worldwide to publish this.
So, first off, this is not new. The linked publication here mainly seems to be explaining a potential mechanism of how it might happen.
Some quick notes to aid in a constructive discussion - bear with me, it's been a while and I've left research and since worked as a software developer, chuckle:
- Different gadolinium agents have vastly different "buildup" characteristics - some are better, some are worse. Biochemically, the ones where the gadolinium was trapped in harder "complexes", those were more stable (less accumulation). I suck at biochemistry, so all of those words may be wrong.
- If you'd want to over-engineer this, you could indeed select your MRI hospital / practice based on which gadolinium agent they use.
- Unless you're getting a ton of MRIs (think multiple sclerosis monitoring etc.), you probably won't be affected.
- Most MRIs are without contrast agent anyway, so you probably won't be affected.
- The last I heard was that the clinical implications were still being investigated - like, yeah, you do see a buildup of gadolinium in patients who 1) get certain gadolinium agents and 2) have a ton of MRIs, but what does that mean they'll suffer any clinical consequences from this? Not sure. I heard that there was a paper (.. somewhere) which at least showed a correlation with worse MS outcomes of people who had a high buildup, but then again, cause-effect here is not clear as people with worse MS tend to have more MRIs, too (correlation != causation).
I had an MRI with contrast once. I remember the gadolinium injection made me extremely nauseous for a few minutes, but otherwise it has had zero effect on me personally.
Some sad advice: don't ask doctors about this, my experience is that it will cause them to write you off as a crazy person no matter how you bring it up. Many of them lump this in with what they see as "influencer illnesses", whether fairly or not.
And maybe more practically, if you really need an MRI, whatever you might have is much more likely to hurt you.
36 comments
[ 2.4 ms ] story [ 59.9 ms ] threadThat's why we don't give MRI's out the wazoo. We actually gatekeep them a lot, and most research will tell you that investigative MRIs without chief complaints are a bad idea and we don't do them.
I had cancer. I had no MRIs, but multiple CT and PET scans. CT scans and PET scans have risk - they don't just do those for kicks. But you know what else has risks? Cancer. So there's a calculus here.
Every single medical procedure, down to getting your blood drawn, has this calculus. Nothing is risk free.
Here in Germany you have to sign something if they give you "stuff" informing you of possible risks. Something that always exists.
Unfortunately, the article isn't much better. It has as an underpinning, a corrected paper: https://doi.org/10.1093/ndt/gfl294
> She said that the FDA's plan doesn't go far enough.
> "It's hard to dismiss an anecdotal report when you are the anecdote. When a patient is finally tested and found to have gadolinium retention, there's no FDA-approved antidote. So what does the patient do?"
And I want to reiterate that she was "the" no not "a" no. I don't know if her vote alone is what's caused more research into this. But it's probably the thing I brag about her the most. Even though everybody else said it was fine or abstained, she stood strong. If you look up the articles from the time of the panel (2017) you'll see a lot of articles about this panel and how she was the sole no vote. Included in that was a public post from Chuck Norris praising her. He was going to come out to meet us but I think it was a bad Texas hurricane season so that fell through
Like somebody else mentioned, they swore up and down it's perfectly safe.
https://www.frontiersin.org/journals/toxicology/articles/10....
The Cleveland Clinic has a good overview[1]. Since there have been no reports of NSF in 15 years, I don't think it's rational to avoid MRIs based on gadolinium retention concerns.
[1] https://www.ormanager.com/briefs/study-mri-contrast-agent-ca...
A dose of ibuprofen could give you Stevens–Johnson syndrome or TENS and you end up in a burn war for months.
Patients should be made aware of all the risks for any treatment, but it would be impossible to avoid they edge cases even with relatively basic medical care.
So, first off, this is not new. The linked publication here mainly seems to be explaining a potential mechanism of how it might happen.
Some quick notes to aid in a constructive discussion - bear with me, it's been a while and I've left research and since worked as a software developer, chuckle:
- Different gadolinium agents have vastly different "buildup" characteristics - some are better, some are worse. Biochemically, the ones where the gadolinium was trapped in harder "complexes", those were more stable (less accumulation). I suck at biochemistry, so all of those words may be wrong.
- If you'd want to over-engineer this, you could indeed select your MRI hospital / practice based on which gadolinium agent they use.
- Unless you're getting a ton of MRIs (think multiple sclerosis monitoring etc.), you probably won't be affected.
- Most MRIs are without contrast agent anyway, so you probably won't be affected.
- The last I heard was that the clinical implications were still being investigated - like, yeah, you do see a buildup of gadolinium in patients who 1) get certain gadolinium agents and 2) have a ton of MRIs, but what does that mean they'll suffer any clinical consequences from this? Not sure. I heard that there was a paper (.. somewhere) which at least showed a correlation with worse MS outcomes of people who had a high buildup, but then again, cause-effect here is not clear as people with worse MS tend to have more MRIs, too (correlation != causation).
[1] https://pubs.rsna.org/doi/full/10.1148/radiol.2015150337
Some sad advice: don't ask doctors about this, my experience is that it will cause them to write you off as a crazy person no matter how you bring it up. Many of them lump this in with what they see as "influencer illnesses", whether fairly or not.
And maybe more practically, if you really need an MRI, whatever you might have is much more likely to hurt you.